Journal of Forensic Psychiatry & Psychology最新文献

The number of older people in prison is increasing, and this group has significant mental health needs. Despite this, little research has evaluated mental healthcare for older prisoners, and examples of best practice are unknown. This paper explored staff experiences of supporting the mental health needs of older prisoners to identify existing forms of care provision, challenges to implementation, and areas for improvement. Eight professionals were recruited to a nominal group discussion, and seven themes were identified: 1) Lack of recognition of mental health problems in prison; 2) Risk factors for mental health problems among older prisoners; 3) Models of working; 4) Specialised environments; 5) Prison transfers; 6) Aftercare post release; and 7) Mental health education. There was consensus that older prisoners are vulnerable to mental health problems, though their needs are not sufficiently recognised nor addressed. While several ideas for improvement were identified, the provision of consistent and effective mental health care for older prisoners is lacking. To identify best practice guidelines for addressing the mental health needs of older prisoners, a valuable next step is to review mental healthcare provision for older people in the community and consider how this could be adapted to a prison environment.

There are increasing numbers of older women in prison in England and Wales. The needs of older women in prison have been under researched and are often unmet. This paper explores staff and expert perspectives on the needs of older women in prison through a nominal group attended by six participants, including a consultant at the UK Health Security Agency; a General Practitioner; a postgraduate student completing a project on older women in prison; an academic researcher with expertise on older women in prison; a National Women's Health, Social Care, and Environment Review Group lead; and a HMMPS Diversity and Inclusion Lead. Six key themes were identified: 1) health screening; 2) health services and unmet health needs; 3) emotional wellbeing; 4) social and family connections; 5) the need for a professional's forum; and 6) limited data and research. Participants agreed that this population's needs are not adequately met. Moving forward, structures must be put in place to ensure that older women's needs are understood and met, and their voices heard.

The number of people aged 50 and over entering the criminal justice system (CJS) in England and Wales is growing. This raises questions as to the suitability of the CJS to equitably accommodate individuals with complex illness or impairment, who might experience difficulties in cognitive function, frailty, and/or impaired mobility. Findings from the government, the third sector, and academic literature have highlighted the difficulties experienced by older adults in the CJS and those tasked with supporting them. To inform the development of the Ministry of Justice's national strategy for older people in prison, we conducted a series of nominal focus groups with policy makers, practitioners, prison staff, representatives from the third sector, and academics, each focusing on a specific topic area that impacts older adults in prison. These were: 1) older adult trajectories; 2) long term conditions; 3) dementia; 4) mental health; 5) social care; 6) end of life care; 7) women; 8) ethnicity; and 9) COVID-19. An additional nominal group was also held with older adults currently in prison to discuss what they thought should be included in the national strategy more broadly. This paper presents the methodology of the nominal groups and subsequent analysis, as well as providing a rationale for the research. It serves as a precursor to a series of papers reporting and discussing the findings of the topic-specific nominal groups.

Throughout the COVID-19 pandemic, concerns were raised regarding the vulnerability of prisoners to infection from the virus, leading to numerous changes to prison regimes and healthcare delivery. A nominal group was conducted exploring the experiences and views of prison staff involved in supporting older adult prisoners in England and Wales during times of COVID-19, including considering improvements in prison healthcare that can be applied beyond the pandemic. The group included seven participants with relevant knowledge and experience, comprising two consultants in public health, four heads of prison healthcare, and a prison governor. Three key themes emerged from the analysis of the group discussions: 1) Impact and uses of technology; 2) Changes to prison regimes; and 3) The importance of purposeful activities. Further research is needed to understand the impact and effectiveness of digital technologies in prisons during the pandemic, specifically telemedicine, including understanding which circumstances and patient groups these provide most benefit in. Furthermore, prisons should ensure that the health and social care needs of older adults are considered when designing prison regimes and offering educational and recreational activities.